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1.
Journal of Korean Medical Science ; : e96-2023.
Article in English | WPRIM | ID: wpr-967394

ABSTRACT

In mid-2022, as the wave of pediatric coronavirus disease 2019 (COVID-19) cases escalated in South Korea, a public-private partnership was made to establish a Pediatric COVID-19 Module Clinic (PMC). We describe the utilization of the first prototype children’s modular clinic in Korea University Anam Hospital functioning as the COVID-19 PMC. Between August 1 and September 30, 2022, a total of 766 children visited COVID-19 PMC. Daily number of patient visits to the COVID-19 PMC ranged between 10 and 47 in August; and less than 13 patients per day in September 2022. Not only the model provided timely care for the COVID-19 pediatric patients, but it also enabled safe and efficacious care for the non-COVID-19 patients in the main hospital building while minimizing exposure risk to severe acute respiratory syndrome coronavirus 2 transmission. Current description highlights the importance of spatial measures for mitigating in-hospital transmission of COVID-19, in specifically on pediatric care.

2.
Journal of Korean Medical Science ; : e317-2021.
Article in English | WPRIM | ID: wpr-915479

ABSTRACT

Public interventions have shown to optimize the use of antibiotics in children with acute otitis media (AOM). In this study, we describe the AOM-related antibiotic use among children in South Korea using national cohort data. We retrieved the Health Insurance Review & Assessment Service data to construct a national cohort of children aged 0–6 years who had been diagnosed with AOM between 2012 and 2018. Of 25,212,264 children included, the antibiotic prescription has increased for amoxicillin/amoxicillin-clavulanate from 56.1% in 2012 to 61.8% in 2018. Prescription has decreased for cephalosporin (35.1% in 2012 to 31.8% in 2018) and macrolide (8.7% in 2012 to 6.4% in 2018). National cohort data have shown an increased trend in AOM-related aminopenicillin prescription and downward trend cephalosporin and macrolide use in South Korea. A multi-faceted approach is required to control the antimicrobial resistance at a population level.

3.
Yonsei Medical Journal ; : 588-594, 2018.
Article in English | WPRIM | ID: wpr-715904

ABSTRACT

PURPOSE: Dysregulation of the Wnt pathway is a crucial step in the tumorigenesis of colorectal cancer (CRC). This study aimed to determine whether DNA methylation of Wnt pathway genes helps predict treatment response and survival in patients with metastatic or recurrent CRC. MATERIALS AND METHODS: We retrospectively collected primary tumor tissues from 194 patients with metastatic or recurrent CRC. Pyrosequencing was used to examine the methylation of 10 CpG island loci in DNA extracted from formalin-fixed paraffin-embedded specimens. To elucidate the predictive role of DNA methylation markers, Kaplan-Meier survival estimation and Cox regression were performed for progression-free survival and overall survival (OS). RESULTS: The methylation frequencies of the 10 genes analyzed (p16, p14, MINT1, MINT2, MINT31, hMLH1, DKK3, WNT5A, AXIN2, and TFAP2E) were 47.9%, 10.8%, 21.1%, 16.0%, 20.6%, 0.5%, 53.1%, 32.0%, 2.6%, and 2.1%, respectively. We divided patients into three groups based on the number of methylated genes (group 1, no methylation n=38; group 2, 1–2 methylations n=92; group 3, 3 or more methylations n=64). Among patients treated with palliative chemotherapy (n=167), median OSs of groups 1, 2, and 3 were 39.1, 39.7, and 29.1 months, respectively (log rank p=0.013). After adjustment, number of methylations was identified as an independent poor prognostic factor (0–2 methylated vs. ≥3 methylated: hazard ratio, 1.72; 95% confidence interval, 1.16–2.56, p=0.007). CONCLUSION: This study suggests that methylation of Wnt pathway genes, in addition to known CpG island methylator phenotype markers, may help predict treatment outcome and survival in patients with CRC.


Subject(s)
Humans , Carcinogenesis , Colorectal Neoplasms , CpG Islands , Disease-Free Survival , DNA , DNA Methylation , Drug Therapy , Methylation , Phenotype , Retrospective Studies , Treatment Outcome , Wnt Signaling Pathway
4.
Cancer Research and Treatment ; : 1378-1387, 2018.
Article in English | WPRIM | ID: wpr-717515

ABSTRACT

PURPOSE: Melanoma is a highly heterogeneous neoplasm, composed of subpopulations of tumor cells with distinct molecular and biological phenotypes and genotypes. In this study, to determine the genetic heterogeneity between primary and metastatic melanoma in Korean melanoma patients, we evaluated several well-known genetic alterations of melanoma. In addition, to elucidate the clinical relevance of each genetic alteration and heterogeneity between primary and metastatic lesions, clinical features and patient outcome were collected. MATERIALS AND METHODS: In addition to clinical data, BRAF, NRAS, GNAQ/11 mutation and KIT amplification data was acquired from an archived primary Korean melanoma cohort (KMC) of 188 patients. Among these patients, 43 patients were included for investigation of tumor heterogeneity between primary melanoma and its corresponding metastatic lesions. RESULTS: Overall incidence of genetic aberrations of the primary melanomas in KMC was 17.6% of BRAF V600, 12.6% of NRAS mutation, and 28.6% of KIT amplification. GNAQ/11 mutation was seen in 66.6% of the uveal melanoma patients. Patients with BRAF mutation were associated with advanced stage and correlated to poor prognosis (p < 0.01). Among 43 patients, 55.8% showed heterogeneity between primary and metastatic lesion. The frequency of BRAF mutation and KIT amplification significantly increased in the metastatic lesions compared to primary melanomas. GNAQ/11 mutation showed 100% homogeneity in uveal melanoma patients. CONCLUSION: Our data demonstrated heterogeneity between primary melanomas and corresponding metastatic lesions for BRAF, NRAS mutation and KIT amplification. However, GNAQ/11 mutation was genetically homogeneous between primary and metastatic melanoma lesions in uveal melanoma.


Subject(s)
Humans , Cohort Studies , Genetic Heterogeneity , Genotype , Incidence , Melanoma , Phenotype , Population Characteristics , Prognosis
5.
Cancer Research and Treatment ; : 473-482, 2016.
Article in English | WPRIM | ID: wpr-210749

ABSTRACT

PURPOSE: The purpose of this study is to investigate the prognostic significance of SOX2 gene amplification and expression in patients with American Joint Committee on Cancer stage III lung squamous cell carcinoma (SCC) who underwent surgery followed by adjuvant radiotherapy. MATERIALS AND METHODS: Pathological specimens were obtained from 33 patients with stage III lung SCC treated with surgery followed by adjuvant radiotherapy between 1996 and 2008. SOX2 gene amplification and protein expression were analyzed using fluorescent in situ hybridization and immunohistochemistry, respectively. Patients were divided into two groups according to their SOX2 gene amplification and protein expression status. Kaplan-Meier estimates and a Cox proportional hazards model were used to identify the prognostic factors affecting patient survival. RESULTS: The median follow-up period for surviving patients was 58 months (range, 5 to 102 months). SOX2 gene amplification was observed in 22 patients and protein overexpression in 26 patients. SOX2 overexpression showed significant association with SOX2 gene amplification (p=0.002). In multivariate analysis, SOX2 overexpression was a significant prognostic factor for overall survival (OS) (hazard ratios [HR], 0.1; 95% confidence interval [CI], 0.002 to 0.5; p=0.005) and disease-free survival (DFS) (HR, 0.15; 95% CI, 0.04 to 0.65; p=0.01). Age (HR, 0.33; 95% CI, 0.11 to 0.98; p=0.046) and total radiation dose (HR, 0.13; 95% CI, 0.02 to 0.7; p=0.02) were the independent prognostic factors for OS and DFS. Patients with SOX2 amplification did not show a longer OS (p=0.95) and DFS (p=0.48). CONCLUSION: Our data suggested that SOX2 overexpression could be used as a positive prognostic factor in patients with stage III lung SCC receiving adjuvant radiotherapy.


Subject(s)
Humans , Carcinoma, Squamous Cell , Disease-Free Survival , Follow-Up Studies , Gene Amplification , Immunohistochemistry , In Situ Hybridization, Fluorescence , Joints , Lung Neoplasms , Lung , Multivariate Analysis , Proportional Hazards Models , Radiotherapy , Radiotherapy, Adjuvant
6.
Cancer Research and Treatment ; : 853-858, 2016.
Article in English | WPRIM | ID: wpr-132150

ABSTRACT

Sinonasal mucosal melanoma (SMM) is an aggressive and rare type of melanoma. Although the classic RAS-RAF-MEK pathway is thought to be the main pathway involved in melanoma pathogenesis, genetic alterations in the phosphatidylinositol 3-kinase-AKT pathway, including PTEN-regulated signaling, are also thought to contribute. So far, data regarding altered PTEN expression and epigenetic mechanism of PTEN silencing in development of SMM is extremely limited. Herein we report on a case of SMM with liver and bone metastases with an epigenetic alteration of PTEN. Results of mutation analysis for BRAF, NRAS, HRAS, KRAS, PIK3CA, c-Kit, and PTEN were negative; however, methylation of PTEN CpG islands was observed. Our case not only supports PTEN as a major tumor suppressor involved in melanoma tumorigenesis, but also a potential epigenetic mechanism of PTEN silencing in development of SMM.


Subject(s)
Carcinogenesis , CpG Islands , Epigenomics , Liver , Melanoma , Methylation , Neoplasm Metastasis , Phosphatidylinositols
7.
Cancer Research and Treatment ; : 853-858, 2016.
Article in English | WPRIM | ID: wpr-132147

ABSTRACT

Sinonasal mucosal melanoma (SMM) is an aggressive and rare type of melanoma. Although the classic RAS-RAF-MEK pathway is thought to be the main pathway involved in melanoma pathogenesis, genetic alterations in the phosphatidylinositol 3-kinase-AKT pathway, including PTEN-regulated signaling, are also thought to contribute. So far, data regarding altered PTEN expression and epigenetic mechanism of PTEN silencing in development of SMM is extremely limited. Herein we report on a case of SMM with liver and bone metastases with an epigenetic alteration of PTEN. Results of mutation analysis for BRAF, NRAS, HRAS, KRAS, PIK3CA, c-Kit, and PTEN were negative; however, methylation of PTEN CpG islands was observed. Our case not only supports PTEN as a major tumor suppressor involved in melanoma tumorigenesis, but also a potential epigenetic mechanism of PTEN silencing in development of SMM.


Subject(s)
Carcinogenesis , CpG Islands , Epigenomics , Liver , Melanoma , Methylation , Neoplasm Metastasis , Phosphatidylinositols
8.
Cancer Research and Treatment ; : 208-215, 2016.
Article in English | WPRIM | ID: wpr-170064

ABSTRACT

PURPOSE: Hypermethylation of the CpG island of p16(INK4a) occurs in a significant proportion of colorectal cancer (CRC). We aimed to investigate its predictive role in CRC patients treated with 5-fluorouracil, leucovorin, irinotecan (FOLFIRI), and cetuximab. MATERIALS AND METHODS: Pyrosequencing was used to identify KRAS mutation and hypermethylation of 6 CpG island loci (p16, p14, MINT1, MINT2, MINT31, and hMLH1) in DNA extracted from formalin-fixed paraffin-embedded specimens. Logistic regression and Cox regression were performed for analysis of the relation between methylation status of CpG island methylator phenotype (CIMP) markers including p16 and clinical outcome. RESULTS: Hypermethylation of the p16 gene was detected in 14 of 49 patients (28.6%) and showed significant association with KRAS mutation (Fisher exact, p=0.01) and CIMP positivity (Fisher exact, p=0.002). Patients with p16-unmethylated tumors had significantly longer time to progression (TTP; median, 9.0 months vs. 3.5 months; log-rank, p=0.001) and overall survival (median, 44.9 months vs. 16.4 months; log-rank, p=0.008) than those with p16-methylated tumors. Patients with both KRAS and p16 aberrancy (n=6) had markedly shortened TTP (median, 2.8 months) compared to those with either KRAS or p16 aberrancy (n=11; median, 8.6 months; p=0.021) or those with neither (n=32; median, 9.0 months; p < 0.0001). In multivariate analysis, KRAS mutation and p16 methylation showed independent association with shorter TTP (KRAS mutation: hazard ratio [HR], 3.21; p=0.017; p16 methylation: HR, 2.97; p=0.027). CONCLUSION: Hypermethylation of p16 was predictive of clinical outcome in metastatic CRC patients treated with cetuximab and FOLFIRI, irrespective of KRAS mutation.


Subject(s)
Humans , Colorectal Neoplasms , CpG Islands , Cyclin-Dependent Kinase Inhibitor p16 , DNA , Drug Therapy , Fluorouracil , Genes, p16 , Leucovorin , Logistic Models , Methylation , Multivariate Analysis , Phenotype
9.
Annals of Dermatology ; : 485-490, 2014.
Article in English | WPRIM | ID: wpr-124798

ABSTRACT

BACKGROUND: Genetic alterations have been identified in melanomas according to different levels of sun exposure. Whereas the conventional morphology-based classification provides a clue for tumor growth and prognosis, the new classification by genetic alterations offers a basis for targeted therapy. OBJECTIVE: The purpose of this study is to demonstrate the biological behavior of melanoma subtypes and compare the two classifications in the Korean population. METHODS: A retrospective chart review was performed on patients found to have malignant melanoma in Severance Hospital from 2005 to 2012. Age, sex, location of the tumor, histologic subtype, tumor depth, ulceration, lymph node invasion, visceral organ metastasis, and overall survival were evaluated. RESULTS: Of the 206 cases, the most common type was acral melanoma (n=94, 45.6%), followed by nonchronic sun damage-induced melanoma (n=43, 20.9%), and mucosal melanoma (n=40, 19.4%). Twenty-one patients (10.2%) had the chronic sun-damaged type, whereas eight patients (3.9%) had tumors of unknown primary origin. Lentigo maligna melanoma was newly classified as the chronic sun-damaged type, and acral lentiginous melanoma as the acral type. More than half of the superficial spreading melanomas were newly grouped as nonchronic sun-damaged melanomas, whereas nodular melanoma was rather evenly distributed. CONCLUSION: The distribution of melanomas was largely similar in both the morphology-based and sun exposure-based classifications, and in both classifications, mucosal melanoma had the worst 5-year survival owing to its tumor thickness and advanced stage at the time of diagnosis.


Subject(s)
Humans , Classification , Diagnosis , Hutchinson's Melanotic Freckle , Lymph Nodes , Melanoma , Neoplasm Metastasis , Prognosis , Retrospective Studies , Solar System , Ulcer
10.
Journal of the Korean Neurological Association ; : 270-272, 2013.
Article in Korean | WPRIM | ID: wpr-221321

ABSTRACT

Posterior reversible leukoencephalopathy syndrome (PRLS) is a disorder that is characterized by reversible white-matter edema affecting the posterior regions of the brain. There are rare cases in which cyclosporine has been cited as a medication responsible for PRLS, which causes hypoperfused ischemia by endothelial injury and vasoconstriction, with resultant vasogenic edema. A PRLS patient in whom the condition was induced by cyclosporine is described herein. Perfusion computed tomography revealed a clinically relevant hypoperfused area, including the zones of vasogenic edema.


Subject(s)
Humans , Brain , Cyclosporine , Edema , Ischemia , Leukoencephalopathies , Perfusion , Vasoconstriction
11.
Journal of the Korean Neurological Association ; : 254-257, 2013.
Article in Korean | WPRIM | ID: wpr-84942

ABSTRACT

A 57-year-old man developed motor weakness and paresthesia after acute enteritis. Nerve conduction study revealed decreased compound muscle action potentials in median nerves and conduction blocks in ulnar nerves. Serum IgG anti-GM1 antibody was positive. Conduction blocks rapidly disappeared through sequential studies, which are defined as reversible conduction failure (RCF). This study represents anti-GM1 antibody-associated acute motor conduction block neuropathy based on RCF. We underline that serial nerve conduction studies might be required for characterization of clinical and electrophysiological features.


Subject(s)
Humans , Middle Aged , Action Potentials , Enteritis , Immunoglobulin G , Median Nerve , Muscles , Neural Conduction , Paresthesia , Ulnar Nerve
12.
Journal of the Korean Neurological Association ; : 62-65, 2013.
Article in Korean | WPRIM | ID: wpr-86634

ABSTRACT

No abstract available.


Subject(s)
Alzheimer Disease , Autopsy
13.
Yonsei Medical Journal ; : 883-887, 2013.
Article in English | WPRIM | ID: wpr-99050

ABSTRACT

PURPOSE: Phosphatidylinositol 3-kinases/AKT pathway plays a pivotal role in hepatocellular carcinoma (HCC). Mutant PIK3CA, encoding the p110a catalytic subunit, stimulates the AKT pathway and promotes cell growth in various cancers. PIK3CA mutation rate has been usually reported as low frequency (<5%) in HCC except one report from Korea with 35.6%. Therefore, we investigated the frequency of PIK3CA mutations in Korean HCC patients. MATERIALS AND METHODS: We sequenced exons1, 3, 4, 6, 7, 8, 9, 19 and 20 of PIK3CA in 268 HCC tumor tissue samples by Sanger method and pyrosequencing assay. RESULTS: In this study, the mutations were not detected in exons3, 6, 8, and 19, and detected 1 at unknown SNP in exon1 and exon4, 2 at unknown SNP in exon7, 2 at unknown SNP in exon20. However, 1 at unknown SNP, 1 at G1635T and surprisingly all samples at A1634Cin exon9 were detected by Sanger method. Additional experiments with normal tissue, cloning experiments and a pyrosequencing assay revealed that the double peak at A1634C of exon9 is a pseudogene, not true mutation. The mutations found in this study were all different and small numbers, therefore, we cannot conclude specific relationship between clinical characteristics of HCC and mutation of PIK3CA. CONCLUSION: Our study suggests that the rate of PIK3CA mutation in the Korea population is in fact similar to the rates seen elsewhere in the world.


Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Asian People/genetics , Carcinoma, Hepatocellular/genetics , Exons , Liver Neoplasms/genetics , Mutation , Mutation Rate , Phosphatidylinositol 3-Kinases/genetics , Polymorphism, Single Nucleotide , Republic of Korea
15.
Journal of the Korean Neurological Association ; : 33-36, 2012.
Article in Korean | WPRIM | ID: wpr-211786

ABSTRACT

Moyamoya disease is a cerebrovascular disorder characterized by progressive stenosis of the distal internal carotid arteries, and in rare cases can occur in association with optic disc coloboma. We describe a 31-year-old man with transient left-sided weakness caused by steno-occlusion of the bilateral internal carotid arteries. A fundoscopic examination revealed a coloboma involving the optic disc of the right eye. Clinicians should be aware of the possibility of moyamoya disease in patients with optic disc coloboma, even when other classic symptoms of this disease are absent.


Subject(s)
Adult , Humans , Carotid Artery, Internal , Cerebrovascular Disorders , Coloboma , Constriction, Pathologic , Eye , Moyamoya Disease
16.
Journal of the Korean Neurological Association ; : 60-62, 2012.
Article in Korean | WPRIM | ID: wpr-211779

ABSTRACT

No abstract available.


Subject(s)
Hydrocephalus, Normal Pressure , Myotonic Dystrophy
17.
Hanyang Medical Reviews ; : 91-102, 2010.
Article in Korean | WPRIM | ID: wpr-58036

ABSTRACT

Acupuncture is an important portion of Complimentary and Alternative Medicine and has been applied widely, but understanding of acupuncture is not complete, a steady progress has been made in recent years with modernized techniques. The controversies of acupuncture should be defined through scientific evidence. There are a lot of problems for application of acupuncture in practice and research, such as, in the diagnosis, therapy and evaluation of acupuncture. We need standardized tools and scientific methods for diagnosis and treatment. It is an essential key to refine the effect of acupuncture and to prove the mechanisms. We should have basic concepts of acupuncture and apply it objectively for promotion of health and prevention of illness and treatment of disease as mentioned in Medical Acupuncture. Korean Hand Acupuncture Therapy (KHT) has many advantages for this purpose. It was found and developed in 1971 and since has been widely used in the world. KHT is easy to learn and to practice without side effect. The important concept of health in KHT is defined as the harmonized state of cerebral circulation which consists of anterior and posterior circulation. Disease and dysfunction result from imbalance of the anterior and posterior circulation. We present the basic concept of KHT and some studies to prove the mechanism of acupuncture using thermograph, transcranial Doppler and fMRI. We need a standard research protocol of acupuncture. KHT can be a good candidate for this purpose. KHT fulfills the requirements such as role, theory, diagnosis, treatment and evaluation and study.


Subject(s)
Acupuncture , Acupuncture Therapy , Complementary Therapies , Hand , Health Promotion , Magnetic Resonance Imaging
18.
Journal of the Korean Neurological Association ; : 135-137, 2010.
Article in Korean | WPRIM | ID: wpr-77819

ABSTRACT

No abstract available.


Subject(s)
Brain , Brain Neoplasms , Neurosyphilis
19.
Journal of Korean Medical Science ; : 1038-1044, 2009.
Article in English | WPRIM | ID: wpr-203392

ABSTRACT

Myotonia congenita (MC) is a form of nondystrophic myotonia caused by a mutation of CLCN1, which encodes human skeletal muscle chloride channel (CLC-1). We performed sequence analysis of all coding regions of CLCN1 in patients clinically diagnosed with MC, and identified 10 unrelated Korean patients harboring mutations. Detailed clinical analysis was performed in these patients to identify their clinical characteristics in relation to their genotypes. The CLCN1 mutational analyses revealed nine different point mutations. Of these, six (p.M128I, p.S189C, p.M373L, p.P480S, p.G523D, and p.M609K) were novel and could be unique among Koreans. While some features including predominant lower extremity involvement and normal to slightly elevated creatine kinase levels were consistently observed, general clinical features were highly variable in terms of age of onset, clinical severity, aggravating factors, and response to treatment. Our study is the first systematic study of MC in Korea, and shows its expanding clinical and genetic spectrums.


Subject(s)
Adult , Child, Preschool , Humans , Infant , Male , Young Adult , Amino Acid Sequence , Asian People/genetics , Base Sequence , Chloride Channels/genetics , DNA Mutational Analysis , Exons , Korea , Molecular Sequence Data , Myotonia Congenita/genetics , Point Mutation , Protein Conformation
20.
Journal of Korean Medical Science ; : 1015-1023, 2009.
Article in English | WPRIM | ID: wpr-78430

ABSTRACT

This study was performed in order to characterize the types of the infiltrating cells, and the expression profiles of major histocompatibility complex (MHC) class I and membrane attack complex (MAC) in patients with inflammatory myopathies and dysferlinopathy. Immunohistochemical stains were performed using monoclonal antibodies against several inflammatory cell types, MHC class I, and MAC in muscles from inflammatory myopathies and dysferlinopathy. There was significant difference in the types of infiltrating cells between polymyositis (PM), dermatomyositis (DM), and dysferlinopathy, including significantly high CD4+/CD8+ T cell ratio and B/T cell ratio in DM. In dysferlinopathy, CD4+ T cells were the most abundant and the proportions of infiltrating cell types were similar to those of DM. MHC class I was expressed in muscle fibers of PM and DM regardless of the presence of inflammatory infiltrates. MAC was expressed in necrotic fibers and vessels of PM and DM. One patient with early stage DM had a MAC deposits on endomysial capillaries. In dysferlinopathy, MAC deposit was also observed on the sarcolemma of nonnecrotic fibers. The analysis of inflammatory cells, MHC class I expressions and MAC deposits may help to differentiate dysferlinopathy from idiopathic inflammatory myopathy.


Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Dermatomyositis/immunology , Genes, MHC Class I , Membrane Proteins/genetics , Muscle Fibers, Skeletal/cytology , Muscle Proteins/genetics , Muscular Dystrophies, Limb-Girdle/immunology , Myositis/immunology , Polymyositis/immunology , T-Lymphocytes/cytology
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